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Wednesday, April 30, 2014

Esha Homenauth - A Student Perspective: Immunization Delay in Nigerian Infants

The advent of immunization is arguable the most significant public health intervention of the last century. However, in third world countries like Nigeria, there is a delay in the receipt of vaccines that evidently put children at heightened risk for acquiring vaccine-preventable diseases, as well as pose a health threat at the population level. Acquiring vaccines at predetermined ages ensures that children are protected as early as possible against specific diseases (Luman et al., 2002). Delay in the commencement of immunization creates a spiraling host of concerns such as: delay in completion of immunization, resulting in a pool of susceptible unimmunized children that may contribute to epidemics (NVAC, 1991). In Nigeria, poor compliance of vaccines at birth, like the first dose of hepatitis B, Oral Polio and BCG vaccines are reported; therefore, identifying the factors that contribute to such delays are imperative, such that immunization programs can be tailored to limit the incidence of untimely vaccine initiation.

In a study conducted by Sadoh et al.,(2013) published in the Tanzania Journal of Health Research Vol 15, No.3, the factors associated with the delay in commencement of immunization in Nigerian infants were assessed. In this study, a cross-sectional, descriptive approach was undertaken, involving 153 consecutive mothers of infants present for their first immunization at the Institute of Child Health Child Welfare Clinic of the University of Benin, Benin City. 

Findings of this study highlighted that only children born in healthcare facilities were likely to commence vaccination on time; whereas, children born outside of facilities were more likely to receive late or missed vaccines. Additionally, some vaccines were only available on specific days of the week, thereby creating an additional barrier to timely immunization. Mother's lack of knowledge about the role of vaccines is also a factor owing to delay in coverage. This factor alludes to the role that health care professionals must take in order to communicate the importance of timely vaccine coverage. Women with high socioeconomic status, maternal education above secondary school and delivery in a health facility were significantly associated with receiving immunization in the first week of life.

Health education that emphasizes the need for timely vaccine coverage is a suggested solution to deal with the incidence of immunization delays. In this study, it is observed that antenatal care and immunisation session health education activities as well as health care workers are important sources of health care information, since the majority of mothers get their information from health care-related sources. Therefore, improvements in these resources are likely to result in improvements in immunization coverage.

In Western societies, there is a growing trend of vaccine-hesitant parents who are concerned about the safety and efficacy of vaccines, resulting in a decline in vaccine coverage. However, in Nigeria, this situation is quite different. Individuals are vaccinating their children later or not at all as a result of poor resources and insufficient knowledge about the importance of vaccines. With Bioline International providing open access to this article, and other articles in this journal, this concern can be addressed at a wider forum so that relevant policy implications can be made to deal with this issue. The tremendous role of vaccines have been documented over the last century; therefore, mechanisms in place to improve the current immunization efforts in Nigeria are imperative, such that children can be vaccinated on time in order to prevent the unwanted resurgence of vaccine preventable diseases.

Sadoh, A.E., Wilson, E.S., Uduebor, J., Ekpebe, P., Iguodala,O.(2013)Factors contributing to delay in commencement of immunisation in Nigerian infants. Tanzania Journal of Health Research, 15(3):1-8

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Wednesday, April 02, 2014

Featured Issue: Revista Colombia Médica Vol.44 No.4

Revista Colombia Médica was recently updated on Bioline.

Vol.44 no.4 includes "Ocular trauma from land mines among soldiers treated at a University Hospital in Medellín, Colombia" by Moreno et al. This study examines patients with ocular trauma from injuries sustained in military combat and the treatment and visual outcomes during the healing process. 

Soldiers who suffered land mine trauma and were studied at the Pablo Tobon Uribe Hospital. The injuries of the soldiers were sustained during the time period of January 2004 to December 2012. The medical history of 635 soldiers was examined, and 153 of the soldiers had ocular trauma. 226 eyes in total were examined. 97.3% of the eyes had medical treatment and 49.1% of them also had surgery. Open ocular trauma was observed in 29.6% of the total number of eyes examined. 11 of the 635 were declared legally blind at the time of discharge. 

The article concludes that landmines can cause extreme ocular trauma, and that more effective treatments are the primary closure of the globe and systemic antibiotics. The Ocular Trauma Score, which was calculated in 183 of the 635 eyes, could be a useful tool to determine the visual outcome of ocular trauma sustained from land mines.

For this article and other articles from this issue, click here.

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